This study is to compare the effect of lisofylline to placebo on incidence of Day 28 mortality in patients with Acute Lung Injury or Adult Respiratory Distress Syndrome. Patients will be randomized to one of two different ventilator strategies. A small volume of oxygen will be compared to a large volume in an unblinded fashion. Patients will be randomly assigned to receive lisofylline or placebo in a blinded fashion. Scatter nurse hours are utilized for pharmacokinetics in patients in the intensive care units.